West Virginia Department of Health and Human Resources
Bureau for Behavioral Health and Health Facilities
Behavioral Health is Essential to Health
Prevention Works
Treatment is Effective
People Recover
Improving the quality of life for West Virginians with behavioral health needs
Funded by:
This training is funded by a grant from the U.S. Department of Health
and Human Services, Substance Abuse and Mental Health Services
Administration, Center for Substance Abuse Prevention, and the
West Virginia Department of Health and Human Resources,
Bureau for Behavioral Health and Health Facilities.
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Recognize drugs of abuse currently trending
in WV
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Learn ways to prevent drug abuse
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Determine how to recognize signs and
symptoms of drug use
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Alcohol and tobacco will remain principal
drug threats to WV because of existing high
levels of abuse, availability and accessibility
Pharmaceutical abuse (opiates) has
registered as a significant problem, reaching
into every county in WV
Marijuana will continue to be the most widely
available and commonly abused illicit drug in
WV.
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Methamphetamine production has increased
since 2006 and has spread throughout the
state.
The threat posed by Synthetic Drugs such as
Bath Salts and Synthetic Marijuana (K2) has
been on the radar since 2010 and has risen
significantly in 2011.
Cocaine has been found in WV but has not
shown a significant increase in use during the
recent past.
Alcohol is alcohol is alcohol…
Source: National Institute for Alcohol Abuse and Alcoholism
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Alcohol affects your self-control
Alcohol depresses your central nervous
system, lowers your inhibitions, and impairs
your judgment
Drinking can lead to risky behaviors, such as
driving when you shouldn’t, or having
unprotected sex
Missing work-calling in sick when you have a
hangover
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Getting drunk on a regular basis
Lying about how much alcohol he or she is
using
Believing that alcohol is necessary to have
fun
Having frequent hangovers
Feeling run-down, depressed, or even suicidal
Having "blackouts"--forgetting what he or
she did while drinking
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Tobacco is addictive. Cigarettes contain
nicotine-a powerfully addictive substance.
Three-quarters – 75% - of young people who use
tobacco daily continue to do so because they
find it hard to quit.
Tobacco can kill you. Smoking is the leading
preventable cause of death in this country. More
than 440,000 Americans die from tobaccorelated causes each year, and most of them
began using tobacco before the age of 18.
Cannabis and Hashish: Weed, Pot, 420, Grass,
Hash, Joints, Mary Jane, Chronic, Herb, Dope
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It increases heart rate
It causes anxiety, paranoia, panic attacks
It causes impaired memory and learning
Contributes to accidents to self and others
 Automobile
 Household
 Occupational
The average potency of marijuana has
more than doubled since 1998
There are also synthetic forms of marijuana
which are chemically based and more potent
Source: National Center for National Products Research
Mehmedic, Z. et al. (2010) Potency trends of THC and other cannabinoids in confiscated
cannabis preparations from 1993 to 2008. Journal of Forensic Sciences, 55(5), 1209-1217.
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Specific odor
Rolling papers, baggies, empty canisters
Pipes, bongs, other smoking devices
Abundance of incense
Source: Google Images
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Narcotics/Opioids
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Inhalants
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Synthetic Drugs
 Street: heroin
 Prescription pain killers
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Stimulants
 Cocaine and crack
 Bath Salts
 Methamphetamine
 K2/Spice
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Drugs used medicinally to relieve pain
Have a high potential for abuse and dependence
 tolerance builds quickly; user needs more and more to
get same effect
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Cause relaxation with an immediate “rush”
Initial unpleasant effects – restlessness, nausea
Street vs. Prescription Narcotics
 Street Narcotic: Heroin (Smack, Horse, Junk)
 Prescription Narcotics (Vicodin, Percodan, Demerol,
Oxycontin, Methadone, Codeine)
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Usually smoked, injected, sniffed, or taken orally
Use causes confusion, itching, constipation,
blocks pain messages to brain
Increases risk of Hepatitis and HIV if injected
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Oxycodone (OxyContin, Percodan, Percocet)
Propoxyphene (Darvon)
Hydrocodone (Vicodin, Lortab, Lorcet)
Hydrmorphone (Dilaudid)
Meperidine (Demerol)
Diphenoxylate (Lomotil)
Morphine (Kadian, Avinza, MS Contin)
Codeine
Fentanyl (Duragesic)
Methadone
Minimum $1 per milligram
on the street, but this is on
the rise due to tightening of
prescription drug laws.
Street Value:
Approximately
$10 per pill
25
20
15
18.8
14.9
12.0
10
19.3
18.5
12.0
12.1
9.5
5
0
2008
2009
Source: Kaiser State Health Facts
2010
2011
WV
US
WV
40
36.5
Percent Reporting Use
35
30.7
30
26.6
25
26.6
24.8
21.5
18.3
20
15
10
26.7
12.0
13.8
9.2
5
0
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Source: WV Health Statistics Center
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Possible effects: “euphoria,” drowsiness,
respiratory depression, constricted (pinpoint) pupils
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Withdrawal
 Watery eyes, runny nose, yawning, cramps
 Loss of appetite, irritability, nausea
 Tremors, panic, chills, sweating
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Cocaine, Amphetamines, Methamphetamines
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High potential for abuse/dependence
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These are used to:
 relieve fatigue and increase alertness
 feel stronger and more decisive
 to counteract tranquilizers and alcohol
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Dextroamphetamine (Dexedrine and
Adderall)
Methylphenidate (Ritalin and Concerta)
Source: www.justice.gov/dea
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Street Names: Coke, Dust, Snow, Blow,
Powder, Lines, Rock (Crack Cocaine)
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It is illegal – in any form
Even first-time users can have seizures or fatal
heart attacks
It is expensive – regular users can spend
hundreds or thousands of dollars on cocaine
each week
Cocaine impairs judgment and increases risk for
 poor decision-making (financial, breaking the law)
 HIV/AIDS and Hepatitis
 being the victim of rape and/or unplanned
pregnancy
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“Meth” is an extremely powerful and addictive
stimulant that affects the nervous system
Street Names: Speed, Meth, Crank, Chalk, Ice,
Glass
300
271
250
200
171
140
150
109
100
As of April 16, 2013, there
have been 124 reported
labs for 2013.
50
0
2009
2010
2011
2012
Source: WV Bureau for Public Health, Office of Environmental Health Services
Source: WV Bureau for Public
Health, Office of Environmental
Health Services
01
HANCOCK
2012
Methamphetamine Lab
Notifications
BROOKE
OHIO
WETZEL
MONONGALIA
MARION
MARION
TYLER
02
02
RITCHIE
09
BARBOUR
BARBOUR
03
WIRT
01
22
01
ROANE
07
05
GRANT
05
05
HARDY
03
RANDOLPH
09
PENDLETON
01
08
WEBSTER
07
KANAWHA
85
POCAHONTAS
NICHOLAS
20
LINCOLN
03
02
TUCKER
TUCKER
01
BRAXTON
15
20
WAYNE
07
CLAY
PUTNAM
CABELL
09
HAMPSHIRE
02
LEWIS
JACKSON
04
MINERAL
04
WOOD
MASON
PRESTON
TAYLOR
BOONE
FAYETTE
Total Lab Notifications:
2012: 271
GREENBRIER
02
01
LOGAN
RALEIGH
05
MONROE
WYOMING
MCDOWELL
MERCER
2011: 171
2010: 140
2009: 109
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Indications of possible misuse:
 Excessive activity, talkativeness, irritability,
argumentativeness or nervousness
 Increased blood pressure or pulse rate, dilated
pupils
 Long periods without sleeping or eating
 Euphoria
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1 in 5 teens have used inhalants to get high –
starting in elementary school
Sudden Sniffing Death Syndrome (SSDS)
Erowid.org
Common Household Items
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Glues/adhesives
Nail polish remover
Markers
Air duster
Spray paint
Butane lighter fluid
Typewriter correction
fluid
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Gasoline
Propane gas
Household cleaners
Cooking sprays
Whipping cream cans
A/C coolants
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Signs of inhalant abuse:
 Sitting with a pen/marker near nose
 Constantly smelling clothing sleeves
 Showing paint or stain marks on fingers, face
or clothing
 Hiding rags, clothes, or empty containers of
potentially abused products in closets or other
places
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Prolonged use can lead to:
 Red or runny eyes or nose, without a cold
 Nausea and/or loss of appetite
 Chronic use symptoms of anxiety, excitability,
irritability or restlessness
 Major organ and tissue damage
 Link between car painting in 1960s to
Parkinson’s Disease
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Bath Salts
K2/Spice (synthetic marijuana)
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Bath Salts are synthetic stimulant drugs
VERY DANGEROUS: addictive and
potentially lethal
More potent than cocaine
Not organic-made with chemicals
They do not contain fragrant soaps or oils,
yet they are packaged to seem so
Crystalized powder that can be
white to brown, with shades in
between and even speckled.
 Typically an attractive package
about the size of a tea bag.
 The label says “Not for Human
Consumption”
 Manufactured mainly in China or
India. There are labs in the US…
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Bath Salts abuse and problems associated
with abuse are increasing at an alarming rate.
2009-no calls to Poison center for bath salts
2010-304 calls
(WV reported 4)
2011-6,138 calls
(WV reported 253)
2012-2,656 calls
(WV reported 45)
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Synthetic drugs
Synthesized to mimic effects of marijuana
More potent than THC
Not organic-made with chemicals (sprayed
on plant material)
When burned this substance usually has a
pleasant odor…
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America’s poison centers first received calls
about “synthetic marijuana” in late 2009
 2,960 calls in 2010--36 calls in WV
 6,955 calls in 2011--77 calls in WV
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80% of these calls placed from ER, compared
to 20% regularly
It produces a high similar to that of marijuana
It doesn't contain tetrahydrocannabinol (THC), the
psychoactive chemical in marijuana
 K2 contains synthetic chemicals, known as JWH-018
and JWH-073, that mimic THC by acting on the
cannabinoid receptors in the brain
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 It binds with the CB1 receptor and produces a euphoric
effect or high in humans. JWH-018 binds with CB1
receptors at a rate four times greater than THC (natural or
synthetic)
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The common marijuana drug tests are calibrated to
detect THC and THC metabolites, not the synthetics
used in Spice or K2
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Smoked in joints
Smoked in pipes
Mixed in tea
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Spice
K2
Genie
Yucatan
Fire
Sense
Smoke
Black Mamba
Fake Weed
Designer drugs
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Skunk
Bliss
Bombay Blue
Zohai
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Dizziness
Nausea
Vomiting
Anxiety
Paranoia
Rapid Heart Beat
Increased Blood Pressure
Loss of Consciousness
Paranoid Behavior
Intense Hallucinations
Agitation
Seizures
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Alcoholics Anonymous 1-800-333-5051
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Narcotics Anonymous 1-800-766-4442
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Suicide Prevention Lifeline 1-800-273-8255
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WV Prescription Drug Abuse Quit-line
1-866-987-8488
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WV Poison Control 1-800-222-1222
Center for Substance Abuse Prevention (CSAP):
www.samhsa.gov
 National Drug Intelligence Center:
www.usdoj.gov/ndic/index.htm
 National Institute on Drug Abuse: www.nida.nih.gov/drugpages
 Street Drugs: www.streetdrugs.org
 National Institute on Alcohol Abuse and Alcoholism:
www.niaaa.nih.gov
 Kaiser State Health Facts: kff.org/statedata
 Drug Enforcement Agency: www.dea.gov
 www.TheAntiDrug.com
 www.freevibe.com
 www.putingkidsfirst.org
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www.lifematters.com
 k2spicediamond.com/
(this is an internet store)
 stopthedrugwar.org
 k3spice.blogspot.com/
(this is an internet store)
 CADCA Webinar – Designer Drugs: The New Frontier
 Northern New England Poison Center www.nnepc.org
 Bangor Police Department, Bangor, ME
www.bangormaine.gov/cs_ps_police.php
 Maine Drug Enforcement Agency www.maine.gov/dps/mdea
 Web MD www.webmd.com
 American Association of Poison Control Centers
www.aapcc.org
 Office of National Drug Control Policy
www.whitehousedrugpolicy.gov
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Some slides/pictures were adapted from
presentation materials by:
Rebecca Miller, MPH, BSN, RN, CSPI, CHES
Northern New England Poison Center
miller@mmc.org
207-662-7224
Michael Ang-Rabanes, MD
Chestnut Ridge Hospital, Morgantown, WV
Cathy Coontz, MA, MS, PSII, NPN
Prevention Lead for WV and
National Prevention Network for WV
Division on Alcoholism and Drug Abuse
Bureau for Behavioral Health and Health Facilities
350 Capitol Street, Room 350
Charleston, WV 25301
Cathy.E.Coontz@wv.gov